Working Mindfully with Physical Pain

Pain can offer an invitation to soften, writes Mark Coleman, the founder of the Mindfulness Institute.

I've suffered off and on for years with chronic back pain, which has only gotten worse with age. As much as I try to take care of my body and exercise regularly, my body, like all bodies, is subject to wear and tear, aches and pains, and at times chronic conditions.

No one is immune.

Everyone has a particular burden to carry.

So I’m always curious how each one of us shows up to meet our particular physical challenges—with openness and kindness or with resentment and reactivity?

The invitation as a human being is to learn to face what comes with this physical form. Whatever pain or condition you struggle with—arthritis, fatigue, psoriasis, sporting injuries, or anything else—can you welcome it with an open and kind attention? This is the orientation of mindfulness practice, which helps us reframe difficult experiences from being a burden into being a chalice of growth and understanding. In working with our own pain in this way, we learn to open our heart to ourselves and broaden compassion for all those who suffer physically.

Take a moment now to reflect on how you face pain or other hard stuff in life. Mindfulness practice trains us to open to the conditions of this moment with a receptive awareness, yet typically, our first impulse is to do the opposite. Ajahn Chah, a beloved Thai meditation teacher, summarized our usual orientation to pain: “By running away from suffering, we run toward it.” That is so often our go-to strategy. We try to escape pain in whatever way we can, through distraction, avoidance, and numbing ourselves. We get lost in our digital devices, stay busy, or drown our feelings with entertainment or alcohol. And who can blame us? Hanging out with discomfort and physical pain is hard.

Another common reason we resist and avoid pain is the belief that if we feel the difficulty, we will be quickly overwhelmed and dragged into a well of suffering and despair. Yet it is the very running away that often adds to our stress and prolongs our misery.

Mindfulness, on the other hand, helps develop a capacity to stand in the midst of challenging experience and develop the skill to bear witness to that truth. By staying in the present moment and not being driven by anticipatory thoughts of future pain, we have more resources to deal with any difficulty. Indeed, not buying into catastrophic thoughts helps us remain steady in the midst of the pain. Research has shown that mindfulness practice helps reduce anticipatory fear of something negative or painful. This can spare us from a lot of anxiety about what is to come. It also allows a much quicker recovery from a difficult experience by being present for what is happening now, rather than being lost in the painful memory of the past.

Similarly, a 2008 pain study considered older adults with chronic low back pain who took part in an eight-week mindfulness meditation program. The increased body awareness of participants led to better pain-coping skills, in part through the use of “conscious distraction.” Conscious distraction sounds paradoxical, but it simply means averting one’s attention to something less painful or difficult. This allows a sense of ease and restoration in the moment, and it increases one’s capacity to deal with pain when it returns. This is an invaluable skill to learn when one has chronic pain. I use it often when my own pain levels are high; at times, it is more skillful to shift the attention elsewhere to bring temporary relief, which allows a relaxing of the nervous system.

What does it look like to actually turn toward pain? It means to simply turn the light of awareness toward the experience. This means we take time to feel, sense, and inhabit the unpleasant and difficult sensations with a soft, curious attention. It requires some courage to lean into the physical difficulty and to feel all the nuances of that tender experience. By doing so we sense how pain isn’t a monolithic experience, which the label “pain” implies. It is actually an ever-changing flow of sensations—pulsing, vibrating, stabbing, and searing, along with pressure, density, heat, and tightness—all swirling together.

One thing we discover is that pain does not endure forever. It is always a shape-shifting dance of experience, ebbing and flowing depending on all sorts of factors, many of which are out of our control. Pain may not go away for a long time, but it rarely stays the same for more than two moments.

What is important to understand is how our experience of pain is influenced by the quality of our attention. If we meet pain with resistance and fear, or with an agenda to get rid of it, it often feels worse because we grip in contraction against it. If we meet pain with a sense of surrender, of softening the contraction or the tight muscles around it, this can increase a sense of space or ease, even when the difficult experience continues. This lessening of reactivity is possible, but it requires perseverance and patience, which is why meditation is referred to as a “practice.” Practice requires practice!

ATTUNING TO PAIN WITH KIND ATTENTION

The next time you are in physical pain or feel discomfort in your body, try this meditation, which is an invitation to explore pain with mindfulness. Settle your body into the most comfortable position that allows your body to rest. Try to release any tension you are holding in your jaw, belly, facial muscles, and shoulders.

Gently shift your attention to the felt sensations of whatever discomfort or painful experience is present. Try to release the concept or label of “pain,” and instead connect with the direct physical experience. Can you sense the periphery of the painful area? What are the sensations like? Notice what happens when you bring your awareness to this area. Does it change the experience, making it grow in intensity or fade? Keep exploring this area as if this were the first time you had ever felt this, and sense all of the changing nuances of the experience.

In particular, notice the “unpleasant” or painful quality of the sensation. This might be a quality of sharpness, pressure, pinching, stabbing, or searing heat. This unpleasantness is what we react to and try to push away, reject, or resist. Yet the more we can accommodate the unpleasant sensations, however difficult, the more we can find a steadiness of presence with them.

If you find it too difficult to stay with the pain or you feel too reactive to it—which can happen when we hurt too much or have become too weary—switch your attention to something less difficult. For example, feel your breath, listen to sounds inside or outside, or attune to a place in your body where there is no pain, possibly in your hands or feet. Seek a refuge to rest the attention.

If there is nowhere in your body that is a calm refuge, then open your eyes for a moment and take in something uplifting, such as the sky, a flower or plant, or anything that is beautiful in or outside your room. In that way you can regulate your reactivity by turning awareness to that which brings ease or lightness. Once a sense of balance is reestablished, then you can again sense the pain but from a more spacious perspective. You may find you need to move your attention back and forth many times from the difficult stimulus to something pleasant as a way of staying balanced in relation to the pain. Utilize this principle throughout your day as a support for finding greater ease whenever physical pain or unpleasant sensation arises.